Healing through care

OOn the evening of 22 May 2017, our lives as a family changed forever. I, my husband Darah, and our daughter, Catherine, left our home excited to go to Catherine’s first ‘proper’ arena pop concert – Ariana Grande at the Manchester Arena. What began as a family outing became a night of unimaginable trauma, when a suicide bomber detonated an explosive device in the foyer of the venue. The blast claimed 22 lives and injured hundreds more. Yet, within this devastating event, our story of survival, resilience and exceptional hospital care unfolded – one that highlights the crucial role of surgical teams, paediatric wards and multidisciplinary support services.

This article focuses not on the horror of that night but on the care we received in the days and months that followed. From emergency surgical interventions to personalised paediatric support, the NHS teams at the Royal Manchester Children’s Hospital, Manchester Royal Infirmary, Wythenshawe Hospital and Royal Bolton Hospital played a critical part in helping us begin our journey towards recovery.

Immediate response and emergency triage

In the chaotic moments following the explosion, we struggled through the confusing situation as best we could. We were all in pain and bleeding, yet alive. While the hospitals in Manchester were inundated with casualties, emergency protocols quickly came into effect. Darah was admitted to the Royal Bolton Hospital, while Catherine and I were taken to Royal Manchester Children’s Hospital, where we remained for over two weeks. Though separated from Darah, we were enveloped in the blanket of NHS care – structured, compassionate and swift.

Surgical interventions: a multi-stage process

The injuries sustained by us all were consistent with proximity to a high-velocity explosive device. We all suffered from shrapnel wounds; Catherine had injuries to her head, arms, chest, back and legs, while my foot and leg were significantly damaged with a fractured calcaneum, and significant trauma to my soft tissue on both legs. Darah had suffered less trauma so, consequently, was transferred to the Royal Bolton Hospital from the scene rather than central Manchester as per emergency protocols. He remained an inpatient for five days.

Initially, staff on the paediatric unit made what would become a pivotal decision: to keep me on the children’s ward at the Royal Manchester Children’s hospital with Catherine. We were admitted initially to the children’s ward together but were moved later that day to the paediatric burns unit, where we could share a single room with our beds side by side. 

That single act of flexibility – understanding the patient as part of a family system – became a foundation for our recovery. It wasn’t just the right thing for Catherine, it was the right thing for me. Even though I was hurt, I was still her Mum. That gave me purpose. It was the right thing for Darah, too, who was safe in the knowledge that I was with Catherine while he was separated from us both. 

We all required surgical attention. The initial surgery was to remove shrapnel and leave the wounds open. We found out later that this process was based on advice received from Army personnel to reduce infection risk. 

I was due to go to theatre on the first day following the event, but Catherine’s surgery was repeatedly delayed. I couldn’t face the prospect of being in theatre whilst Catherine headed down for surgery without me. Thankfully, I was stable and the surgeons agreed to delay my surgery until the following day. For this I will be forever grateful. A return trip to theatre was necessary a few days later to perform a secondary repair with the necessity for intravenous antibiotics. However, the staff had to make do with paediatric IV giving sets for me – adult equipment was requested from the adult surgical wards but being at opposite ends of the hospital site presented practical issues at times. Occasionally my care was delayed but never to any detriment.

Catherine’s care included wound management. She had also suffered a shattered fibula and eventually we found out that she had suffered complete hearing loss in her right ear from shrapnel – this was a life-changing event for us all.

I underwent two surgical procedures: one to stabilise my wounds (as mentioned previously) and another for flap surgery and the surgical closure of my other wounds.

The flap surgery performed on my leg was a major point in my physical recovery. This was undertaken by a plastic surgeon from Wythenshawe Hospital. It involved rotating the skin from my upper calf to the lower heel. The resulting wound was a shock to me but I understand now that it was necessary. Unfortunately, part of the wound became unstable after my return home. However, I later discovered that this is very common with skin flaps/grafts and that they need to heal by ‘secondary intention’.

Catherine was ready to be discharged after two weeks so I was transferred to the adult surgical ward for another couple of days. Obviously, I could not stay in the lovely environment of the children’s unit so this was a rather traumatic transition. I felt isolated due to the different environment I found myself in. I didn’t receive the same level of emotional support, possibly because the team had not known me and my situation from day one.

A life-changing diagnosis

The audiology department was tasked with testing the hearing of those injured at the arena. Catherine had already realised there was a problem. However, we were so busy undergoing various surgical procedures that we hadn’t given it much attention. After repeat testing, it was confirmed that Catherine had profound sensorineural hearing loss in her right ear. She went to theatre for a third time while still an inpatient for a steroid injection into her eardrum. This was repeated as a day case after discharge but neither procedure made a difference to her hearing. She now has an Osia device, which was implanted in January 2022. This helps but is by no means perfect.

Difficult aftercare for Catherine

If there is one thing I wish I could change, it was the process of suture removal for Catherine. She had numerous sutures. Of course, we thought their removal would be a relatively simple procedure – this happens across the world every day without an issue at all. However, we had underestimated the impact of the pain Catherine would suffer during suture removal. She had regular visits over several weeks to the paediatric burns clinic. The staff were amazing. Initially, all of the sutures were removed during one visit. This was distressing for Catherine. She was sedated with gas and air but still screaming with pain. The process led to Catherine developing anxiety around simple procedures, such as injections and taking blood. I would rather some thought had been given to their removal under general anaesthetic. I don’t express that lightly – I would never want my child to undergo a general anaesthetic unnecessarily. 

Beyond surgery: the art of healing in paediatric care

Perhaps one of the most profoundly impactful aspects of our experience was the holistic, emotionally intelligent care provided in the children’s ward. We were inundated with visits – from consultants to managerial staff, police officers, psychologists and nurses. It was such a whirlwind every day that I struggled to find the time and energy to help Catherine practically. I was exhausted. We found the multidisciplinary team supported emotional resilience – physiotherapists worked with Catherine but never forgot she was a child. She had sutures in her scalp and part of her hair had been shaved. One day they came in and plaited her hair. Such a normal act of kindness. She hadn’t smiled for days. That gesture… it wasn’t medical but it mattered.

Catherine, naturally shy and emotionally withdrawn after the trauma, responded well to these non-clinical interventions. The play therapist encouraged her to create artwork for her twin brothers, James and Matthew, who were sitting their A levels and whose 18th birthday occurred while we were still hospitalised. These activities helped Catherine regain a sense of control and emotional expression during a time of upheaval. This took some pressure off me. I struggled to support Catherine due to my own situation. I felt guilty – as a Mum I couldn’t take care of her as I would have normally. 

A particularly touching gesture came from the ward staff, who arranged for us to celebrate the twins’ milestone birthday together. With support from the Ronald McDonald House charity, the team coordinated a private celebration, complete with cake and decorations. In an extraordinary act of empathy, staff also celebrated my and Darah’s wedding anniversary on the ward, an act that underscored the hospital’s commitment to family-centred care.

Psychological support and trauma management

While surgery repaired our bodies, trauma requires a more nuanced, long-term approach. In the weeks following the attack, we began experiencing symptoms of post-traumatic stress disorder (PTSD). Thanks to support from the newly founded Greater Manchester resilience hub, I was able to access counselling and began practising mindfulness, relaxation and distraction techniques.

Catherine, on the other hand, struggled to articulate her emotions. In the days after the event, hospital staff recognised this and worked with us to provide psychological support at a pace that respected her emotional state. The children’s ward provided a safe space where Catherine could begin to heal without being forced to recount traumatic details. In this way, the staff honoured the principle that emotional recovery in children often begins not with words, but with connection and care.

A child psychologist visited us on the ward and even arranged to come when Darah was due to visit us on the day of his hospital discharge. He talked to us as a family. At the time, Darah was planning to get back to work as soon as possible. The psychologist knew we would all need to support each other, both physically and mentally, on our return home and provided Darah with a reality check.

Darah, though a medical professional himself, wrestled with guilt and frustration. The severity of the aftermath he witnessed weighed heavily on him. It proved to be some months before he was ready to accept that he would benefit from therapy. We have all since needed more courses of therapy. We have now realised that this event has changed us for life – as individuals and a family.

Multidisciplinary coordination in a time of crisis

The attack placed unprecedented demands on Manchester’s medical infrastructure. The fact that Catherine and I could remain together during our hospital stay was not incidental, it was the result of strategic patient management. Prioritising the preservation of the parent–child bond during trauma recovery is well supported by evidence, and the hospital’s coordination ensured it was possible, even during a mass-casualty event. The hospital management visited us to assess the situation and proved to be a valuable source of communication in the weeks following.

One particular aspect of the multidisciplinary care was that six months and one year after the event, a specific clinic was organised at the children’s hospital to review Catherine – we moved from room to room, seeing the trauma surgeons, a paediatrician, a senior nurse and a mental health worker. It was a ‘one-stop shop’ designed to ensure all patients were monitored and no-one was left behind. Looking back, this was significant help in our recovery – we were listened to.

I also had appointments on a smaller scale, having follow-up appointments with an A&E consultant. He took on the role of checking on the progress of adult patients who had been through A&E that night and was able to follow me up.

Healing through music: the Manchester Survivors’ Choir

The long road to emotional recovery for us found an unexpected ally in music. In 2018, we joined the Manchester Survivors’ Choir, a group formed to bring together those affected by the attack. Our first meeting began as tentative participation and soon evolved into a lifeline of community and expression.

For many, singing with others who had endured the same trauma became a way to calm our minds. When I sing, the chaos in my brain eases. Catherine found her voice in a more literal way, gaining confidence, forming friendships and rediscovering joy. Even Darah, not a natural performer, embraced the choir’s healing power. The experience helped him move past guilt as performance transformed from a challenge into a statement of resilience. The choir also gave us the courage to re-enter spaces that once seemed too frightening,  such as public venues and concerts. Supported by fellow survivors, we stepped back into the world, carrying the weight of our experience but no longer defined by it.

Unexpected support  – rehabilitation

Some months following my hospital discharge, a consultant plastic surgeon from Wythenshawe Hospital contacted me. He had operated on me and other survivors, and had secured funding to set up a rehabilitation project using NHS staff in collaboration with a private facility. The funding was provided by money donated by the public at the time of the incident.

The facility was normally used by a famous Manchester football club – the equipment was state of the art and would not have been available in an NHS hospital.

For months, some of the most seriously injured survivors could receive intensive rehabilitation, including body scans, gait analysis, physiotherapy and mental health support.

I am still so grateful to have been able to receive this care. 

The physiotherapy I had received from the NHS did not suit me. I attended a group ‘leg’ session – it was timed during a hospital fire alarm test! I am sure you can appreciate how this felt. I found myself in a group of patients with leg injuries – fractures, osteoarthritis, sprains.

None of my fellow patients had experienced a terrorist attack or similar trauma. I feel I would have benefitted from one-to-one support – and this was provided by this team.

 It wasn’t just physiotherapy, it was full body fitness. It had a significant impact on my recovery and encouraged me to pursue fitness subsequently – I am a member of a local independent gym and this experience has helped to motivate me. 

Conclusions

Our story is one of survival – but also of extraordinary recovery, facilitated by a healthcare system that rose to meet both the physical and emotional demands of our trauma. The surgical teams provided the technical expertise. Both Catherine and I received excellent aftercare from our surgeons. However, they also collaborated with the broader hospital community – the children’s unit, therapists, administrators and volunteers. They all joined together to help piece together our emotional recovery. 

Surgery often focuses on procedure, clinical expertise and prognosis. Stories like ours remind us that surgical care does not end in the operating theatre. It includes braiding a child’s hair, facilitating a birthday celebration or holding a patient’s hand if words fail.
However, we still suffer. I have pain and nerve injuries as well as PTSD and survivor’s guilt. Going out is more difficult. Catherine also has PTSD and struggles with her hearing. Darah has changed personally and professionally. With the compassionate care provided by the NHS, we have been helped through our trauma and can adjust to a new way of life.